Spokane man sentenced for insurance fraud and attempted theft

Four years after filing a bogus insurance insurance claim that tried to turn $4,000 in storm damage into a $200,000 payment, a Spokane man has been sentenced to 240 hours of community service, 15 days of electronic home monitoring and more than $7,000 in fines.

Keith R. Scribner, seen in the surveillance photo above, was sentenced Friday in Spokane County Superior Court on felony charges of insurance fraud and attempted theft.

The case stemmed from a claim filed in late July 2009 by Scribner's mother, Marilyn Warsinske. She said a patio roof at a home she'd purchased had collapsed due to the weight of snow some 6 months earlier. The policy covered "like kind and quality" replacement. Her son, she told the company, would handle the claim.

Scribner told the insurance company that patio cover was an extensive structure, spanning the entire length of the patio and wrapping around the home's chimney. Claims officials, inspecting the site, wondered why was there no flashing or holes in the masonry. Scribner said that house painters must have made repairs.

He sent the insurance company three bids to replace the cover based on his description. The bids ranged from $195,586 to $213,815.

Claims officials asked Scribner for any photos of the roof prior to the damage or after it collapsed. Perhaps some were taken during a home appraisal prior to the purchase, they suggested. Scribner said there were no photos and was no appraisal.

But a claims handler discovered an aerial photo of the home on a real estate website. It showed a much smaller patio cover than Scribner claimed.

The company launched a fraud investigation and notified Insurance Commissioner Mike Kreidler's anti-fraud Special Investigations Unit.

As it turned out, there had been a home appraisal, the investigators discovered. In fact, Keith Scribner met with the appraiser. And the appraisal included photos of the patio cover. A real estate agent interviewed by investigators described the cover as being "small and nothing special or significant."

The home's previous owner also provided photographs of the structure. It was originally canvas. When that because troublesome to remove each year, the homeowner bought a polycarbonate cover. Cost: About $300.

An architect told a state fraud investigator that he'd met with Scribner in 2008 -- months before the snow collapse -- to discuss plans to replace the deck cover with new, larger one.

A local company, provided with measurements and photographs of the original structure, drew up replacement bids at the request of a state fraud investigator. The bids: $3,913 and $4,782.

New report cites increased flood risk in coming decades

FEMA on Wednesday released a report on flood risk and the potential impact of climate change, particularly sea level rises.

The upshot: the report said that areas considered flood-prone could substantially increase, particularly here in the Pacific Northwest, by the end of this century. The impact on federal flood insurance -- the National Flood Insurance Program -- would be profound, with substantial increases in both cost and the number of policies.

Mother Jones magazine summarized the report here.

Wildfires and homeowners insurance: Five things you need to know

As wildfire season approaches, here are five important things to know about fire danger and your homeowners insurance:

1) Homeowners insurance generally covers all fires, including wildfires, unless the policyholder intentionally set the fire. Outbuildings and unattached structures are also generally covered.

2) If possible, review your policy to make sure you have enough coverage. Things like fine art and jewelry may have limited coverage under a standard policy. But you can buy special coverage that gives you more protection. Here's information to help determine how much

3) Prepare a household inventory, which will help a lot if you have to file a claim. You can do it with these easy-to-use paper forms, or you can try free iPhone/iPad or Android apps that do the same thing.

4) You can help protect a rural home and limit the danger by clearing a natural firebreak between your home and surrounding trees, brush and uncut fields. The Federal Emergency Management Agency has much more information on how to protect yourself and your home, before, during and even after a wildfire.

5) Have an emergency kit and a family communication plan. Know where your valuable papers (including insurance policy and contact info), mementos and anything you can't live without are, so that you can evacuate with them if needed. Here's a list of recommended emergency supplies. And if you're advised to evacuate, do so immediately. Don't be the person in the photo above.

Heads up: New travel insurance license rules in WA

New rules are taking effect July 1 for travel insurance licensing in Washington state. Here's a summary, albeit one that's pretty heavy on insurance-ese:

• Under the new rules, any individual or business entity that will sell, solicit, or negotiate travel insurance must have the travel line of authority specifically listed on their Washington state insurance producer license.

• There is one exception to this new requirement. If a licensed business entity (agency) wants to transact travel insurance business, it must a) have a producer license with the travel line of authority and b) have a designated responsible licensed person for the agency who has a producer license with the travel line of authority.

Got questions? We've prepared an FAQ page on this topic, and if that doesn't help, you'll find contact info (email and phone) at the bottom of the FAQ page.

Average health insurance premiums, by state

Premiums for family health insurance rose an average of 62 percent -- $9,249 a year to $15,022 a year -- according to the latest survey of employer-sponsored insurance by The Commonwealth Fund.

Employees' contributions to their premiums rose 74 percent during the same time period, from an average of $2,283 to $3,962. And deductibles more than doubled, to an average of $1,123 a year.

The report covers the years from 2003 through 2011; it will be a while before we get comprehensive data for health care reform, which takes full effect next year. In the meantime, we've posted the proposed rate filings for Washington on our website.

Among states in the West, Washington is a standout for below-average premiums compared to median household income, the study found. In Oregon, Idaho, California, Montana and Nevada, premiums compared to income were higher. (Click on the map above for more on this.) In pure dollar terms, Idaho is the fifth lowest-cost state in the country, although its average deductibles are significantly higher than Washington's.

The lowest average premiums were in Arkansas; the highest in Massachusetts.

Regardless, "Health insurance is expensive no matter where one lives," the report's writers concluded. "...Across the country, insurance premiums have risen far faster than median (middle) income for the under-65 population.)"

Here are the state average premiums in our region:

• Washington: $5,144 single, $14,559 family
• Oregon: $5,055 single, $14,283 family
• Idaho: $4,553 single, $13,211 family
• California: $5,255 single, $15,837 family

Long-term care insurance: Why have the costs been going up so much, and what can I do?

One of the most common complaints we hear -- and one of the most frustrating -- is from people who have been paying for long-term care insurance for years, but are on the verge of losing the coverage because they can't afford the cost of fast-rising premiums.

Unfortunately, this is a national problem.

So what can you do if the increase is more than you can afford? You can choose to reduce your benefits under the policy, such as:

• Reduce your daily benefit
• Reduce the benefit period duration, such as from five years to two
• Reduce the amount of your optional inflation protections

 You can also choose what's called the contingent non-forfeiture option. Under this option, you keep your policy in force and stop paying premiums. Your coverage does not end, and the company provides benefits for qualified long-term care services covered under your policy -- here's the caveat -- equivalent to the premiums you've paid.

You may also want to look at the Washington state Long-Term Care Partnership Program, a new option to help consumers pay for long-term care costs and avoid spending down or transferring assets to qualify for Medicaid.

Why have long-term care prices been going up so much in recent years?

Long term care insurance is a fairly new product, with many companies not offering it until the early 1990s. As a result, they had little experience to base their prices on, and early policies were priced significantly lower than they should have been, based on how the cost of claims and the fact that -- unlike life insurance, for example -- few people cancel the policies. People get the policies, knowing they may well need them when they're older, and they tend to keep them.

 

As a result, most long-term care insurers have bumped up their premiums sharply in the past few years -- in some cases 40 percent or more -- angering customers who signed up for policies at relatively low cost years ago.   This puts insurance regulators in a bind. Consumers are understandably unhappy. But if regulators reject the rate increases, the insurance carriers could run into financial trouble, leaving them unable to pay claims. And nationally, a number of insurers have simply gotten out of the business of issuing new long-term care policies, which leaves consumers with even fewer choices. (In Washington, there are still a large number of companies approved to sell the coverage. Here's a list.)      

Stevens County woman convicted of insurance fraud over fake claims

A Stevens County woman has been convicted insurance fraud for claims she filed after a fire of undetermined origin destroyed her home in 2011.

Jenny Rae Balsz, 44, of Colville, pleaded guilty May 28, 2013 in Stevens County Superior Court. She was sentenced to 30 days in jail, which she'll be allowed to serve as 240 hours of community service, plus fines and fees of $850.

(If you suspect someone of insurance fraud, here's how to reach our investigators.)

On the fifth of July, 2011, a fire at Balsz's home in Evans, Wash. burned the structure to the ground. Fire investigators were unable to determine the origin of the fire. At the time, Balsz was in Montana, visiting family.

Her insurance claim included several receipts for a total of $13,899 in items purportedly purchased from a home furnishings store. An investigator for Safeco, Balsz's insurer, later found that Balsz had not purchased any of the listed items at the store. In fact, the store didn't even carry some of the items listed, including antiques and a grandfather clock.

She also submitted a purported receipt for a $6,240 clarinet. The receipt also turned out to be false.

And she submitted a fraudulent $800-a-month lease agreement, claiming that she was paying rent to her landlord. The "landlord" turned out to be her live-in boyfriend; the insurance checks for living expenses went directly to Balsz.

Safeco, as required by law, reported their findings to our office's anti-fraud unit, known as the Special Investigations Unit. After they investigated further, our office sought charges against Balsz.

The charge on which she was convicted is a felony.